Provider Demographics
NPI:1346389269
Name:PISKOTY, DEBORAH ANN (MA, LMFT,CSAC, ICS)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:PISKOTY
Suffix:
Gender:F
Credentials:MA, LMFT,CSAC, ICS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222708 RED BUD RD
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4593
Mailing Address - Country:US
Mailing Address - Phone:715-409-1164
Mailing Address - Fax:
Practice Address - Street 1:229 ROSS AVE STE 201
Practice Address - Street 2:
Practice Address - City:SCHOFIELD
Practice Address - State:WI
Practice Address - Zip Code:54476-6111
Practice Address - Country:US
Practice Address - Phone:715-204-9466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14016101YA0400X
WI927-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42015800Medicaid